Tag: Blumberger

Reading of the Week: rTMS – the New JAMA Psych Paper; Also, Opioid Overdoses (JAMA Net Open) and Green on Peak Mental Health (NYT)

From the Editor

She’s an accomplished person who had succeeded in business and then writing, all the while raising three children; she also has an amazing smile and lights up the room when talking about her kids. But in my office, sick with depression, she can only focus on her losses and failings; the smile is absent.

Depression is common and disabling. Those who are affected in late-life are particularly challenging to treat. Is there a better way? In the first selection from JAMA Psychiatry, Dr. Daniel Blumberger (of the University of Toronto) and his co-authors consider theta burst stimulation, a newer form of rTMS which has shown promise in earlier work. Their study is a randomized noninferiority trial, directly comparing the two versions of rTMS in elderly patients with depression. The result? “We showed that bilateral TBS was noninferior to standard bilateral rTMS in improving depression, and similarly well tolerated, in a real-world sample of older adults with TRD [treatment resistant depression]…” We review the paper and its clinical implications.

In the second selection, Lori Ann Post (of Northwestern University) and her co-authors draw on CDC data to look at opioid overdoses in the United States with a focus on geography. In a JAMA Network Open research letter, they find: “Overall, opioid-involved overdose deaths rates increased steadily in counties of every urbanicity type, although there were distinct temporal wave patterns by urbanicity.”

And in the third selection, Huw Green (of the University of Cambridge) wonders about mental health and mental illness – and worries that the terms are becoming blurred together. Writing in The New York Times, the psychologist concludes: “When we move away from a focus on psychological problems and toward ‘mental health’ more broadly, clinicians stumble into terrain that extends beyond our expertise. We ought to be appropriately humble.”  

This month, the Reading of the Week enters its ninth year. A quick word of thanks for your ongoing interest.


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Reading of the Week: ECT – Safe, Effective but Declining Use. The Lemasson et al. Study on ECT in Quebec

From the Editor

It’s an effective treatment for depression – maybe the most effective. Yet ECT remains highly controversial. Patients routinely ask about its safety; the media portrayal is tough.

This week, we look at two new studies on electroconvulsive therapy. In the first, just published in The Canadian Journal of Psychiatry, the authors consider the use of ECT in Quebec over a 15-year period, finding a decline over time.

An ECT Machine: going the way of the dodo bird?

We also look at a new paper from Acta Psychiatrica Scandinavica considering the safety of ECT, tapping a rich database.

These new papers point to a public health problem: the treatment is incredibly safe (and effective) but used less and less often.

Note: there will be no Reading next week.


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